The “obesity paradox” – is it a positive effect on the course of cardio-vascular events? (A literature review)

Abstract

The aim: to analyze the literature and study the “obesity paradox” phenomenon, pathological conditions and categories of patients with its existence. Methods. The analytical, bibliosemantic, system approach and system analysis methods were used in the work. Results. The article presents the basic current views on the effect of obesity on the cardiovascular disease course according to evidence-based medicine. Randomly analyzed results have shown a decrease in mortality after cardiovascular events in overweight individuals. The “obesity paradox” was revealed in the analysis of 10-year survival after stroke in the Framingham Study patients. In the group of overweight and obese patients, mortality rates after ischemic stroke were lower than in the group with normal body weight ([RR] = 0.70, 95 % CI 0.55–0.90, /M3.005). Researchers suggest that a moderately increased body weight may be associated with previously unknown protective factors. The “obesity paradox” has shown a more favorable course of myocardial infarction among certain categories of patients (with a history of cardiovascular events) with higher body weight. In individuals with heart failure who underwent resynchronisation therapy, high body mass index values were associated with a reduced risk of developing primary endpoints. Predicting the risk of acute coronary syndrome has shown better results in overweight patients. Obese patients have been diagnosed with less severe calcification of the carotid arteries. Numerous theories that explain this phenomenon include the protective function of adiponectin as well as the protective effect of muscle tissue. Conclusions. Overweight in people with various pathologies in certain conditions can improve the course of cardiovascular events, which underlies the “obesity paradox”. In the mechanisms of the “obesity paradox”, the protective properties of adiponectin as well as the protective function of muscle tissue are given the highest priority.